Supplier Questionnaire

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Printed on 21.10.2014 15:23:06 Created by Xcitec ® Software

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Supplier Questionnaire

Supplier:

Questionnaire: SQ-Supplier Self Description (v2.0 - 20110101)

Number:

Status: Created on: Last change:

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Legend

Name Questions marked like this are mandatory fields and must be

filled out. ( )

(X) ( )

Questions with answers in this brackets show you some given answers you can select. You can only choose one answer. [X]

[ ] [X]

Questions with answers in this brackets show you some given answers you can select. You can choose more than one answer.

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Introduction

Dear Partners,

The Supplier Qualification process is the initial stage of Supplier Management @ Siemens for all new suppliers. Existing suppliers will gradually be qualified retroactively with regard to our Supplier Qualification requirements.

The questionnaire "Supplier Self Description (SSD)" is part of the Siemens-wide mandatory and standardized supplier-related qualification process.

Having fulfilled a number of basic business criteria, companies wishing to become a Siemens supplier must meet certain minimum economic, environmental and social performance

standards by completing up to six qualification modules.

This company-wide mandatory and standardized supplier-related qualification process is integrated within our supplier platform click4suppliers easy and releases the supplier for business with Siemens, independent of later product and process related qualifications. Supplier Qualification is a cross-functional process which is driven by the Siemens buyer in close interaction with the supplier.

Link for additional information:

https://w9.siemens.com/cms/supply-chain-management/en/supplier-at-siemens/download-ce nter/Pages/dc.aspx

(below Registration & Communication: Download file "Supplier Self Description (SSD)" )

Yours faithfully Siemens

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Relevant Contacts

Please enter the relevant contacts according to their functions in the following chapters.

Management

Salutation ( ) Ms. ( ) Mr. Title

<No answer given>

Last name

<No answer given>

First name

<No answer given>

Phone

<No answer given>

Mobile

<No answer given>

Fax

<No answer given>

E-Mail

<No answer given>

Org. / Dept.

<No answer given>

Street

<No answer given>

ZIP code

<No answer given>

City

<No answer given>

Country

<No answer given>

Function

<No answer given>

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Sales

<No answer given>

Last name

<No answer given>

First name

<No answer given>

Phone

<No answer given>

Mobile

<No answer given>

Fax

<No answer given>

E-Mail

<No answer given>

Org. / Dept.

<No answer given>

Street

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ZIP code

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City

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Country

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Function

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Quality

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Last Name

<No answer given>

First Name

<No answer given>

Phone

<No answer given>

Mobile

<No answer given>

Fax

<No answer given>

E-Mail

<No answer given>

Org. / Dept

<No answer given>

Street

<No answer given>

ZIP code

<No answer given>

City

<No answer given>

Country

<No answer given>

Function

<No answer given>

Product related environmental protection

<No answer given>

Last Name

<No answer given>

First Name

<No answer given>

Phone

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Mobile

<No answer given>

Fax

<No answer given>

E-Mail

<No answer given>

Org. / Dept.

<No answer given>

Street

<No answer given>

ZIP code

<No answer given>

City

<No answer given>

Country

<No answer given>

Function

<No answer given>

Logistics

<No answer given>

Last name

<No answer given>

First name

<No answer given>

Phone

<No answer given>

Mobile

<No answer given>

Fax

<No answer given>

E-Mail

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Org. / Dept.

<No answer given>

Street

<No answer given>

ZIP code

<No answer given>

City

<No answer given>

Country

<No answer given>

Function

<No answer given>

Additional Contacts

Additional Contact

Basic Company Data

Which type of business is your company focus? [ ] Product related business

[ ] Project- / investment business

[ ] Service business

Does your company already supply Siemens or connected Companies (subsidiary, joint ventures)?

( ) yes

( ) no

If yes, where and since when:

Portfolio

ESN List

UNSPSC for download

__________________________________________________________________________

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Financial

When does your business year start? ( ) January ( ) February ( ) March ( ) April ( ) May ( ) June ( ) July ( ) August ( ) September ( ) October ( ) November ( ) December Currency ( ) EUR ( ) USD __________________________________________________________________________

Total Sales Revenue

2012: <No answer given>

2014 (planned): <No answer given>

What's your effort on R&D (in percent of Total Sales Revenue)

__________________________________________________________________________

How is this Total Sales Revenue spread over the different regions (in percent)? Western Europe

<No answer given>

Eastern Europe

<No answer given>

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<No answer given>

South and Latin America

<No answer given>

Asia and Pacific

<No answer given>

Africa

<No answer given>

Others

<No answer given>

Infrastructure

Number of employees

Please list your production sites

Market

Please list your top 10 customers (Siemens areas and others).

__________________________________________________________________________

Please list your main competitors

Logistics

Has your company already realized an EDI connection? ( ) Yes

( ) No, but possible / aspired

( ) No, not possible / not aspired

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Page: 11 of 12 __________________________________________________________________________

Does you company provide logistic supply systems? ( ) Yes ( ) No ( ) Not relevant If yes, which? [ ] Consignment concept

[ ] Contracts store concept

[ ] Stockpile sourcing

[ ] Synchronized production processes

[ ] Standard parts management

[ ] Individual sourcing

[ ] Kanban

Quality

Does your company have any quality assurance agreements with Siemens? ( ) yes

( ) no

If yes, with whom and since when?

__________________________________________________________________________

Has your QM System been audited by Siemens? ( ) yes

( ) no

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Country specific Questions

Supplier diversity (just relevant for suppliers with registered office in USA) ( ) applicable ( ) not applicable __________________________________________________________________________ Percentage of ownership

<No answer given>

__________________________________________________________________________

Supplier diversity key ( ) N Native American

( ) B African American

( ) A Asian Pacific American

( ) H Hispanic

( ) A Asian Indian American

( ) SB Small Business

( ) SBH Small Business Hub Zone

( ) SBV Small Business Veteran

( ) SD Small Disadvantage Business

( ) WD Woman owned Disadvantage Business

( ) WS Woman owned Small Business